Cardiology Interventions

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CMS Announces New Voluntary
Bundled Payment Model

The Centers for Medicare and Medicaid Services (CMS), through its Innovation Center, released a new voluntary bundled payment model on Jan. 9 called Bundled Payments for Care Improvement Advanced (BPCI Advanced). This model is intended to build on the lessons from the current Bundled Payments for Care Improvement model that will conclude later this year. BPCI Advanced will qualify as an Advanced Alternative Payment Model (Advanced APM) under the Quality Payment Program (QPP) in 2018. Qualified participants (based on either patient counts or payment) are eligible for a five percent bonus in payment years 2019 through 2024. Under the Medicare Access and CHIP Reauthorization Act (MACRA), Advanced APMs must include the use of certified electronic health records, use quality measures similar with those in the Merit-based Incentive Payment System (MIPS) and bear financial risk.

In BPCI Advanced, 32 distinct clinical episodes are available to model participants. Of those episodes, 29 are inpatient, including AMI, cardiac arrhythmia, cardiac defibrillator, cardiac valve, congestive heart failure, coronary artery bypass grafting, pacemaker and percutaneous coronary intervention (PCI). New to this version of BPCI are three outpatient clinical episodes, including PCI. The first cohort of participants will start on Oct. 1, 2018, with a performance period running through Dec. 31, 2023. CMS will provide a second application opportunity in January 2020.

ACC believes that APMs, such as BPCI Advanced, have the potential to enhance patient care and improve the quality of care while lowering Medicare and Medicaid costs. To support members considering participation in APMs, ACC is creating the Alternative Payment Model Framework, launching in February on ACC.org. This tool will help members assess their readiness for APM participation. ACC also maintains an online MACRA hub (ACC.org/MACRA) for members seeking general information on the QPP, including information on Advanced APMs.

U.S. Food and Drug Administration (FDA) Commissioner, Scott Gottlieb, MD, recently announced a new pilot program to improve transparency around clinical trial information to spur innovation and scientific analysis for new drugs.

The Agency plans to continue sharing information around product approvals and improve its transparency regarding clinical study reports that may be advantageous to patients, providers and scientists. Some information on drug approvals is currently shared with the public, but according to complaints, it is done through a complex and confusing format. The FDA plans to initiate talks with drug companies to assess their willingness to participate in the program and then solicit public feedback once the pilot is completed.